OBJECTIVES: The St Jude Medical (SJM) Trifecta bioprosthesis is a recently introduced stented trileaflet pericardial valve designed for supra-annular replacement of the aortic valve (AVR). We sought to evaluate the short-term clinical outcome and haemodynamic performance of the Trifecta valve after AVR. METHODS:A total of 837 patients with severe symptomatic aortic valve stenosis or regurgitation underwent AVR with the SJM Trifecta aortic valve prosthesis between January 2009 and March 2013. All intra-and postoperative data were collected prospectively. At discharge, transthoracic echocardiography was performed. A complete set of echocardiographic data was available in 723 patients. CONCLUSIONS:The SJM Trifecta valve reveals an excellent early haemodynamic performance with low residual MPGs and a low incidence of PPM. Studies with longitudinal clinical and echocardiographic assessments with longer term follow-up evaluation including a comparison with other contemporary bioprostheses are needed.

Results Early postoperative and at 1 year mean pressure gradients (MPGs) in the various groups ranged from 7.2 AE 4.6 to 7.1 AE 2.4 mm Hg and from 10.0 AE 4.3 to 8.0 AE 2.8 mm Hg in the SJM Trifecta group and from 18.0 AE 5.0 to 12.1 AE 3.6 mm Hg and from 17.7 AE 4.5 to 11.8 AE 3.2 mm Hg in the CEPM Ease group, respectively. Likewise, effective orifice areas (EOAs) ranged from 1.7 AE 0.5 to 2.0 AE 0.5 cm 2 and from 1.5 AE 0.3 to 1.7 AE 0.4 cm 2 in the SJM Trifecta group and from 1.3 AE 0.5 to 1.9 AE 0.5 cm 2 and from 1.2 AE 0.3 to 1.8 AE 0.3 cm 2 in the CEPM Ease group, respectively. A marked left ventricular mass (LVM) regression across all annulus sizes was noted in both groups. Severe patient-prosthesis mismatch (PPM) was infrequent overall. Conclusion The SJM Trifecta valve showed lower MPGs early postoperative and at 1 year as well as higher EOA and effective orifice area index early postoperative. No significant differences were detected with regard to LVM regression and PPM.

This study represents the longest follow-up for the St. Jude Medical Biocor prosthesis and shows an excellent durability with a low incidence of valve-related complications.

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